Treatment of Hyperthyroidism in Pregnancy and Birth Defects
Maurizio Clementi,Elena Di Gianantonio,Matteo Cassina,Emanuele Leoncini,Emanuele Leoncini,Lorenzo D. Botto,Pierpaolo Mastroiacovo,Pierpaolo Mastroiacovo +7 more
TLDR
In this paper, the authors examined the association of both drugs with congenital malformations using data from the International Clearinghouse for Birth Defects Surveillance and Research (ICSBRS).Abstract:
Context: Clinical hyperthyroidism is not uncommon in pregnancy, with a reported prevalence of 0.1 to 0.4%. The available antithyroid drugs are propylthiouracil and methimazole/carbimazole. Objectives: In this report we examined the association of both drugs with congenital malformations using data from the International Clearinghouse for Birth Defects Surveillance and Research. Design: The study used a case-affected control analysis and included 18,131 cases with malformations and reported first-trimester exposure to medication. A total of 127 subjects were born to mothers with known first-trimester antithyroid drug exposure. Results: Among the 52 groups of malformations that were analyzed, situs inversus ± dextrocardia, isolated unilateral kidney a/dysgenesis, and cardiac outflow tract defects were associated with prenatal exposure to propylthiouracil based on three, two, and five cases, respectively. Prenatal exposure to methimazole/carbimazole was significantly associated with choanal atresia, omphaloc...read more
Citations
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2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum
Erik K. Alexander,Elizabeth N. Pearce,Gregory A. Brent,Rosalind S. Brown,Herbert Chen,Chrysoula Dosiou,William A. Grobman,Peter Laurberg,John Lazarus,Susan J. Mandel,Robin P. Peeters,Scott Sullivan +11 more
TL;DR: The revised guidelines for the management of thyroid disease in pregnancy include recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile women, hypothyroidism in pregnancy and thyrotoxicosis in pregnancy.
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2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis
Douglas S. Ross,Henry B. Burch,David S. Cooper,M. Carol Greenlee,Peter Laurberg,Ana Luiza Maia,Scott A. Rivkees,Mary H. Samuels,Julie Ann Sosa,Marius N. Stan,Martin A. Walter +10 more
TL;DR: One hundred twenty-four evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.
Journal ArticleDOI
Treatment of graves' disease with antithyroid drugs in the first trimester of pregnancy and the prevalence of congenital malformation
Ai Yoshihara,Jaeduk Yoshimura Noh,Takuhiro Yamaguchi,Hidemi Ohye,Shiori Sato,Kenichi Sekiya,Yuka Kosuga,Miho Suzuki,Masako Matsumoto,Yo Kunii,Natsuko Watanabe,Koji Mukasa,Kunihiko Ito,Koichi Ito +13 more
TL;DR: In utero exposure to MMI during the first trimester of pregnancy increased the rate of congenital malformations, and it significantly increased the rates of aplasia cutis congenita, omphalocele, and a symptomatic omphalomesenteric duct anomaly.
Journal ArticleDOI
Diagnosis and management of Graves disease: a global overview
TL;DR: Measurements of serum levels of TRAb and thyroid ultrasonography represent the most important diagnostic tests for Graves disease, and novel agents that might act on the disease process are currently under evaluation in preclinical or clinical studies, but evidence of their efficacy and safety is lacking.
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Birth Defects After Early Pregnancy Use of Antithyroid Drugs: A Danish Nationwide Study
TL;DR: In this paper, a Danish nationwide register-based cohort study included 817 093 children live-born from 1996 to 2008, and exposure groups were assigned according to maternal antithyroid drug use in early pregnancy: PTU (n = 564), methimazole (MMI)/CMZ), MMI/CMZ and propylthiouracil (PTU).
References
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Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline
Leslie J. De Groot,Marcos Abalovich,Erik K. Alexander,Nobuyuki Amino,Linda A. Barbour,Rhoda H. Cobin,Creswell J Eastman,John H. Lazarus,Dominique Luton,Susan J. Mandel,Jorge H. Mestman,Joanne Rovet,Scott Sullivan +12 more
TL;DR: Practice guidelines are presented for diagnosis and treatment of patients with thyroid-related medical issues just before and during pregnancy and in the postpartum interval, including evidence-based approaches to assessing the cause of the condition, treating it, and managing hypothyroidism.
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Clinical practice guideline: Management of thyroid dysfunction during pregnancy and postpartum: An endocrine society clinical practice guideline
Marcos Abalovich,Nobuyuki Amino,Linda A. Barbour,Rhoda H. Cobin,Leslie J. De Groot,Daniel Glinoer,Susan J. Mandel,Alex Stagnaro-Green +7 more
TL;DR: Management of thyroid diseases during pregnancy requires special considerations because pregnancy induces major changes in thyroid function, and maternal thyroid disease can have adverse effects on the pregnancy and the fetus.
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Fetal and neonatal hyperthyroidism.
TL;DR: Hyperthyroid neonates may be treated with antithyroid drugs, beta-adrenergic receptor blocking agents, iodine, or iodinated contrast agents, and at times, with glucocorticoids and digoxin, and the time course of thyrotoxicosis depends on etiology.
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Hyperthyroidism in pregnancy.
TL;DR: The syndrome of transient hyperthyroidism of hyperemesis gravidarum is defined as severe nausea and vomiting, dehydration, ketonuria, and weight loss of more than 5% by 6 to 9 weeks of pregnancy.
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Methimazole embryopathy: delineation of the phenotype.
Maurizio Clementi,Elena Di Gianantonio,Elisabetta Pelo,Isabella Mammi,Rosaria Teresa Basile,Romano Tenconi +5 more
TL;DR: A specific malformation pattern related to prenatal methimazole exposure and consisting of choanal and esophageal atresia, scalp defects, minor facial anomalies and psychomotor delay is defined.